Serotonin (5-HT), a neurotransmitter, has been implicated in a number of diseases and conditions that originate in the central nervous system. These include diseases and conditions related to sleeping, eating, perceiving pain, controlling body temperature, controlling blood pressure, depression, anxiety, schizophrenia, and other bodily states. R. W. Fuller, Biology of Serotonergic Transmission, ed. Neville V. Osborne, John Wiley and Sons (1982), p 221; D. J. Boullin, Serotonin in Mental Abnormalities 1, John Wiley and Sons (1978), p. 316; J. Barchas, et al., Serotonin and Behavior, Academic Press, New York, N.Y. (1973). Serotonin also plays an important role in peripheral systems, such as the gastrointestinal system, where it has been found to mediate a variety of contractile, secretory, and electrophysiologic effects.
As a result of the broad distribution of serotonin within the body, there is a tremendous interest in drugs that affect serotonergic systems. In particular, 5-HT receptor-specific agonists and antagonists are of interest for the treatment of a wide range of disorders, including anxiety, depression, hypertension, migraine, obesity, compulsive disorders, schizophrenia, autism, neurodegenerative disorders (e.g., Alzheimer's disease, Parkinson's Disease, and Huntington's chorea), and chemotherapy-induced vomiting. M. D. Gershon, et al., “5-Hydroxytryptamine and enteric neurones”, in Chapter 11 of The Peripheral Actions of 5-Hydroxytryptamine, pages 247-273, Oxford University Press, (1989); P. R. Saxena, et al., Journal of Cardiovascular Pharmacology, 15: Supp. 7 (1990).
The major classes of serotonin receptors (5-HT1-7) contain fourteen to eighteen separate receptors that have been formally classified. See Glennon, et al., Neuroscience and Behavioral Reviews, 14, 35 (1990); and D. Hoyer, et al., Pharmacol. Rev., 46, 157-203 (1994). Recently discovered information regarding subtype identity, distribution, structure, and function suggests that it is possible to identify novel, subtype specific agents, having improved therapeutic profiles (e.g. fewer side effects).
For example, the 5-HT2 family of receptors is made up of 5-HT2A, 5-HT2B, and 5-HT2C subtypes, which have been grouped together on the basis of primary structure, secondary messenger system, and operational profile. All three subtypes are G-protein coupled, activate phospholipase C as a principal transduction mechanism, and contain a seven-transmembrane domain structure. There are distinct differences in the distribution of the three 5-HT2 subtypes. The 5-HT2B and 5-HT2A receptors are widely distributed in the periphery, while the 5-HT2C receptor has been found only in the central nervous system, being highly expressed in many regions of the human brain. See G. Baxter, et al., Trends in Pharmacol. Sci., 16, 105-110 (1995).
Subtype 5-HT2A is associated with vasoconstriction, platelet aggregation, and bronchoconstriction. Subtype 5-HT2C is associated with diseases including depression, anxiety, obsessive compulsive disorder, panic disorders, phobias, psychiatric syndromes, and obesity. Very little is known about the pharmacological role of the 5-HT2B receptor. See Jenck et al., Exp. Opin. Invest. Drugs, 7, 1587-1599 (1998); Bos et al., J. Med. Chem., 40, 2762-2769 (1997); Martin et al., The Journal of Pharmacology and Experimental Therapeutics, 286, 913-924 (1998); Bromidge et al., J. Med. Chem., 41, 1598-1612 (1998); Kennett, IDrugs, 1, 456-470 (1998); and Dekeyne, et al., Neuropharmacology, 38, 415-423 (1999). ISAAC, Drugs of the Future, 26, 383-393 (2001).
International Patent Applications WO 00/77001, WO 00/77002, and WO 00/77010 disclose tetracyclic compounds that are reported to possess activity as serotonin agonists and antagonists.
There is currently a need for pharmaceutical agents that are useful to treat diseases and conditions that are associated with 5-HT receptors.